3921--, ------------- L.- .. .- ,
cl�:
NOTE;_
With proper'validation
this. form constitutes an CITY OF LA QUINTA
encroachment permit
APPLICATION FOR PERMIT
PUBLIC- WORKS CONSTRUCTION (ENCROACHMENT)
For the construction of public or private curbs,. driveways, Ipavements:; sidewalks, • parking' -lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit — Class•111-
DATE:, May 28s 2003 Minor*Improvement Permit Class .IV X
LOCATION'OF CONSTRUCTION Tract 29033-1. Jefferson* N6rth of 50th., southbound lane
(Street address, or Description of Location)
PURPOSE OF CONSTRUCTION Block wall lane closure Sketch (attach construction plans if appropriate)
DESCRIPTION OF CONSTRUCTION Lane closure on ' ,.•� t� <,
Jeffexaori S'treet,, southbound
cc F1 r F i c okff ILQ, rta L�
DIM ENSION,OF•INSTALLATION OR REMOVAL.F� �.
gy
SIZE -OF EXCAVATION, IF NEEDED
' APPROXIMATE TIME WHEN WORK WILL BEGIN 5/28/03 "
:APPROXIMATE TIME -OF COMPLETION 6/7/0 D
ESTIMATED CONSTRUCTION COST $ (Including removal of all obstruction; materials, and debris, backfilling, MAY 2 8 2003 com- .
paction and placing permanent resurfacing and/or replacing improvements) .
CITY OF LA QU1NTA
In consideration of, the granting. of this permit, the applicant hereby agrees to:. FINANCE DEPT.
Indemnify, de?end and, save the City-, its authorized agents; officers- representatives and employees, harmless from and against any and all
penalties, liabilities or loss resulting from claims or court action and 'arising out of any accident, loss or damage to persons or property
happening or occurring as a proximate result 'of any work undertaken under the permit granted pursuant to this application.
Notify the' Administrative Authority at least,twenty-four (24) hours in advance of the time when work will.be started.
Comply with. all. applicable City Ordinances, the terns' and conditions of -the permit and all applicable rules and regulations of the City of
La Quinta and to pay for any additional replacementnecessary as the resultof this work.
i
Signature of Apicant or Agent
Trans W6st-Houigiugaa (Bob Turpin) 9966 Htbert . Street; Sara Diego (760)' 801-3623
Name of Applicant•(please print) Business Address Telephone No.
Name of Contractor and Job Foreman Business Address Telephone No.
Contractor's License No. City Business. License .No. .
Applicant's Insurance Company :. Policy. Number
FEES: Subdivision'Improvement Permit — Class I.I I
Public improvements: 3% of estimated construction costs
Private improvements: 3% of estimated construction costs : • iQ
Minor Improvement Permit _ Class IV: See attached schedule F)r3.
Inspection Fee $ PERMIT VALIDATION.
II
Permit Fee 100.00 3921 •
Penalty
Cash Deposit -Surety Bond
if required
TOTAL. $ 100.Od
Receipt No.
Received •by Date `
Recorded by
PERMIT N0.
DATE•APPkO,VED May 28, 2003
EXPIRATIONFDATE May 31, 2004
DATE ISSUED as
Administrative Authority
Raoul, Mart'' xiez, Assistant 'itgtneer .11'
Telephone: (760), 777} 7075
NOTE:
Q.
With proper validationp4
this form constitutes an CITY OF , LA QUINTA ��,'
encroachment permit _ r_
APPLICATION FOR PERMIT
PUBLIC . WORKS CONSTRUCTION (ENCROACHMENT)'
OF T[�9wS
For the construction of public or.. private curbs, driveways,pavements, sidewalks, parking lots, sewers, water mains
and other like public works improvements in connection with MINOR IMPROVEMENTS and APPROVED SUBDIVISIONS
Subdivision Improvement Permit:-- Class III
DATE: `2�03. N -- Minor Improvement Permit Class IV_
LOCATION OF CONSTRUCTION i t ��T' � a/J ��' �� N`a�� ° 6F A-40 5 c1306/*0 1/t
o s 3i
(Street address of Description of Location)' • C G 6
OG �i t% Sketch (attach' construction plans if appropriate).`
PURPOSE OF CONSTRUCTION- ..
DESCRIPTIQN OF.C'ONSTRUCTION
DIMENSION OF INSTALLATION OR REMOVAL. ,
SIZE OF EXCAVATION, IF NEEDED
APPROXIMATE TIME WHEN WORK WILL BEGIN
APPROXIMATE TIME OF COMPLETION %
ESTIMATED CONSTRUCTION COST $
(Including removal.of all obstruction, materials, and debris, backfilling, com-
paction and placing permanent resurfacing and/or replacing improvements)
In consideration of the granting of this.permit, the applicant hereby agrees to:
Indemnify, defend'and save the City, its authorized agents, officers, representatives and employees, harmless from and against any and.all
penalties, liabilities or loss resulting from 'claims or court action and arising out of any accident, loss or damage to persons, or property
happening or occurring as a proximate result of any work undertaken under the permit granted pursuant to' this application.
Notify the Administrative Authority at least twenty-four (24) hours in advance of the time when work will be started.
Comply with all applicable City Ordinances,' the terms and* conditions of the permit and all applicable rules and regulations of the City of
La Quinia and to pay for any additional replacement necessary as the .result of this work.
Signature of Applicant or Agent
146) UJ /.v "1 `l G 9-. /�i-/�c��' �5 T S'�'�v �O i & Cro ct*
Name of Applicant (please print) Business Address Telephone No_ ,
Name:of Contractor and.Job.Foreman Business AddressTelephone No.. ,
Contractor's• License No.. City Business License No. '
Applicant's Insurance Company Policy Number
FEES: Subdivision Improvement Permit — Class III `
Public improvements: 3% of'estimated construction costs
Private improvements: 3% of estimated construction costs
Minor. Improvement Permit Class IV: See attached schedule 4 .
Inspection Fee $ PERMIT VALIDATION
Permit Fee b•
PERMIT N0.
Penalty
Cash Deposit -Surety Bond = DATE APPROVED
if required ; EXPIRATION DATE
TOTAL: $ DATE ISSUED
Receipt No: ' By
Received by Date. . "Administrative Authority `
Recorded by Telephone: (760) 777-7075
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NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION (CALTRANS)-
- - Date Umit
MANUAL OF TRAFFIC CONTROLS FOR CONSTRUCTION AND MAINTENANCE WORK ZONES. - ` . �� etr � .
2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND ° 55
�. TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE. '� ' PmjW Name
ak
_ _ � Storm Drain and Sidewalk
Grading for •
3. THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL'INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN g ,
ACCORDANCE WITH TRAFFIC CONTROL PLANS. t. PdroeContmMr TrafficDoftlCordratUr
4. CONTRACTOR SHALL MAINTAIN A MINIMUM 12' TRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BE A MINIMUM 2' BETWEEN THE EDGE OF CUT AND THE Transwest Housing Tops N Barricades, Inc.
« NEAREST TRAFFIC LANE.. Based an Standard
5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED ATALL'TIMES. - (00)852-TOPS Ron Fifield CALTRANS T-11
-6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR OF DEBRIS AND, i. r Date Permit umber
1 of 2 3/19/03 To Be Issued on Approval
RETURNED TO NORMAL..
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a ROAD 1 9 Z v ; + •`K' -
CONaTRUCTIO ��- /RIGHT LANE •1 Q _ - _ + W
AHEAD i» - AEU ti - • c /WGNT LANF'- -- r • , ` - - > -
�
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DELAY
AHUD
NOTES: 1. ALL TRAFFIC CONTROL DEVICES FOR THIS PROJECT SHALL BE IN ACCORDANCE WITH THE STATE OF CALIFORNIA DEPARTMENT OF TRANSPORTATION (CALTRANS) `
• MANUAL OF TRAFFIC CONTROLS FOR CONSTRUCTION AND MAINTENANCE WORK ZONES : , - s Mpg By • , ° s UmR
. t• 2. TRAFFIC CONTROL SHOWN HEREIN IS THE MINIMUM REQUIRED. ADDITIONAL TRAFFIC CONTROL MAY BE REQUIRED TO FACILITATE PUBLIC SAFETY AND 55
' TRAFFIC FLOW IF DEEMED NECESSARY BY CITY OF LAQUINTA REPRESENTATIVE. . ' = ' : -
3. -THROUGHOUT EACH WORK PERIOD, CONTRACTOR SHALL INSPECT TRAFFIC CONTROL (SIGNS, BARRICADES AND DELINEATORS) AND MAINTAIN SAME IN Installing,Gas Line for New Homes. ,
" ACCORDANCE WITH TRAFFIC CONTROL PLANS. N=ContrecW TmftcCoftlCwftcror
4. CONTRACTOR SHALL MAINTAIN A MINIMUM ITTRAFFIC LANE WIDTH AT ALL TIMES. THERE SHALL BE A MINIMUM 2' BETWEEN THE EDGE OF CUTAND THE r Transwest Housing Tops N Barricades, Inc. -
Y -NEAREST TRAFFIC LANE. • ; :' �' Phons PmperedBy DesedonSWWaiG
, L'I
top q
T . 5. ACCESS TO PRIVATE PROPERTY SHALL BE MAINTAINED AT ALL TIMES. ' - - (800)852-70PS; Ron Fifield CALTRANS T-10
e„�~L ' `• 6. THIS TRAFFIC CONTROL SHALL BE IN PLACE DURING WORK HOURS ONLY. AT END OF THE WORK HOURS, THE ROAD SHALL BE CLEAR.OF DEBRIS AND, u r DOPerms mter
RETURNED TO NORMAL.. " ti t 2 of 2 ` : 3/19/ _,v :To Be Issued on Approval